Whitney Palmer

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Vendor-Neutral Archives: The Rapid Shift in Image Archiving

Published on the Aug. 24, 2012, DiagnosticImaging.com website

By Whitney L.J. Howell

When it comes to image storing, PACS still rule the industry. But vendor-neutral archives (VNAs) — products that help you store and share studies across manufacturer systems — are gaining market share fast.

While only 5.4 percent of the nearly 1.5 billion worldwide imaging studies were stored by VNAs in 2011, VNAs are expected to archive more than 30 percent by 2016, according to a May 2012 InMedica report. In fact, a 2012 KLAS report found 27 percent of providers already plan to include VNAs in their image-storing strategies.

“As we’re moving into health care reform, sharing data with other hospitals to coordinate care will be tough if we have to do it across 10 different PACS vendors,” said Chris Tomlinson, executive director of Radiology Associates of The Children’s Hospital of Philadelphia. “By purchasing a VNA, we could segment ownership from the viewers we read things in. It was like getting out of PACS jail, and it’s a great way for radiology to take a lead role within an institution.”

The shift toward VNA implementation has been — and, by most estimates, will continue to be — rapid. And, it’s a move that will impact your purchasing decisions, your image management, and how you shuttle images between institutions. The question, however, is what those impacts will look like.

Making a Purchase

Whether you work in a private practice or a hospital, roughly one-third of image CDs sent from one institution to another are unreadable because the PACS systems are different. This problem has long been understood as a patient-care issue, but it’s also a financial one, said Steve Tolle, senior vice president for solutions management for Merge Healthcare, vendor for the VNA system iConnect.

“Every image CD sent costs about $15 in addition to staff and physician time,” he said. “A hospital can spend between $60,000 and $70,000 annually on courier costs just shuffling CDs between hospitals. That’s a hard savings that can be had with the enterprise and share functionalities of a VNA.”

But you must be careful when selecting a VNA. Examine potential VNA vendors carefully, said Michael Gray, lead consultant at Gray Consulting, because some have modified their marketing efforts to sell PACS systems as VNAs. After you’ve narrowed your vendor choices down, request quotes from each. Remember, if the price tag is high, you can implement a VNA in stages, such as only replacing your tape library, to control costs.

“Identify what’s the most important thing for you to do right now. Do you want to move all your data? Do you want to stick it in a data center?” Gray said. “Have vendors show you creative pricing for putting in part of a VNA. Few real VNA vendors are so busy chasing the $4 million deals that they’re too busy to tell you what you can do for a couple hundred thousand.”

Impacting Image Storage and Management

Most hospital departments operate in separate worlds, making it difficult to share images across institutions. However, expected increases in team-based care and bundled payments will likely make this business and care model unsustainable.

“Interoperability is where we’re going in this world. We’re going to have to share images, so we can’t have these silos of data sitting around,” Holle said. “VNAs offer an entire view of a facility’s diagnostic images, and they provide a solution for all specialists — the cardiologists, the radiologists, the pathologists and others.”

Merge’s iConnect brings together images from any PACS in an institution and offers replicated content management, a feature that supplements back-up recovery by making and storing elsewhere automatic copies of images and data. iConnect also uses a standardized DICOM format that all vendor equipment can access, Tolle said.

Using a VNA will also impact how you interact with your referring physicians, said Merge’s Kurt Hammond, vice president for interoperability solutions. This tool can help you meet growing patient demands.

“Turnaround time is getting really aggressive as physicians expect faster and faster image reads for their patients,” he said. “With a VNA, you’ll save time because there will only be one place to go for images no matter which department they’re coming from.”

According to Shannon Werb, chief operating and strategy officer for Acuo Technologies, employing a VNA also provides you the autonomy to change how you manage your system or distribute your images without contacting the manufacturer.

Acuo’s VNA product, UCP3, is similar to iConnect. However, in addition to DICOM standards, it supports the global authority on international health information technology interoperability Health Level Seven International (HL7) and Integrating the Healthcare Enterprise (IHE) profiles, including Cross-Enterprise Document Sharing (XDS).

VNAs can also save you the time and money you’d expend when migrating imaging data from an old PACS to a new system. Currently, it’s easier to let your PACS vendor transfer the data because it’s time consuming and can be confusing. Often, vendors change DICOM headers, such as CT of the head to CTHead or HeadCT, making it impossible to find some images if they aren’t categorized correctly in the new PACS. The cost for this service is often between $200,000 and $300,000.

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August 31, 2012 - Posted by | Healthcare | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , ,

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